Newfoundland and Labrador extend use of remote patient monitoring

Eastern Health, the largest health authority in Newfoundland Labrador (NL), has been a pioneer in the use of telehealth and most recently implemented a Remote Patient Monitoring (RPM) solution that provides telehealth in a patient’s home.

This medium for telehealth has enrolled over 1,200 patients, of which 240 are being actively monitored at any given time. The RPM solution provides coaching for patients to self-manage chronic disease and monitors physiological parameters to trigger alerts to notify case managers when an intervention is required.

To date, Eastern Health has concentrated on Type II Diabetes, Chronic Obstructive Pulmonary Disease (COPD), and Congestive Heart Failure (CHF).

Building on its success, the RPM program is expanding to all integrated health authorities in the province, while adding additional chronic diseases, including Chronic Kidney Disease and Mental Health.

“This is a tool in a clinician’s tool box and as such we are aggressively reviewing more use cases for this type of telehealth,” said Steven Lockyer, Regional Director of Healthcare Technology at Eastern Health, who spoke at the Internet of Things in Healthcare conference, held in Toronto in May 2018.

Remote Patient Monitoring enables clinical experts from Eastern Health to provide education, support and coaching for patients with chronic disease by monitoring vital signs, such as blood pressure, blood oxygen levels, weight, etc., enabling patients to better manage their chronic diseases.

The idea is to flag problems before they get serious. “The goal is to provide education and prevent the flare-ups that often lead to Emergency Department visits and hospital readmissions,” said Lockyer.

The expansion will use new technologies and techniques that widen the scope of care that can be provided. It will make use of video, allowing clinicians to observe patients and detect problems through speech and visual cues.

This is especially useful for Mental Health, as sudden changes in observed behavior will likely alter the treatment plan.

“A recent telehealth program, called Jasper, uses Skype and has enabled clinicians to observe how autistic children interact and play in their own environment. It’s saving travel time for those who live hours away from the service offered, if they had to visit in person,” said Lockyer.

Due to the success of the RPM program, Eastern Health is preparing to extend this type of telehealth outside Chronic Disease Management to other areas of the organization;

“We’re now driving telehealth right into the patient’s home,” said Lockyer. “It’s much more convenient for them.”

It also frees up space in the hospital, as well as in the facility’s parking lot, he noted.

And of course, it leads to better outcomes for patients. RPM improves access and allows patients to receive the appropriate level of care, by the appropriate clinician, in the most appropriate setting. The mission, overall, is supporting health at home.

In tandem with telehealth in the home, Eastern Health has been proactive in the use of technologies that protect clinicians, such as geolocating apps to protect workers who work alone visiting patients in their homes.